Dr. Barrios is a pioneer in the treatment of peritoneal metastases in Spain and in the world. He is the founder of the regional program for the treatment of peritoneal surface malignancies of Catalonia. He has more than 30 years of experience in the surgical treatment of abdominal cancers and is a Professor of Surgery and the University of Barcelona. He has lectured extensively on the surgical management of advanced abdominal malignancies both nationally and internationally.
Dr. Barrios is a highly regarded specialist in Peritoneal Oncological Surgery. He boasts extensive training in various facets of this specialty. Specifically, he is an expert in peritoneal carcinomatosis, pseudomyxoma peritonei, peritoneal mesothelioma, advanced ovarian cancer, retroperitoneal tumors, HIPEC (Hyperthermic Intraperitoneal Chemotherapy), and pelvic exenterations, among other treatments and pathologies. He earned his Medical and Surgical degree from the Faculty of Medicine at the University of Barcelona and specialized in General and Digestive System Surgery. Furthermore, he holds a Doctorate from the Faculty of Medicine at the Autonomous University of Barcelona. Dr. Barrios is a trailblazer in peritoneal metastasis treatment in Spain and globally. He is the founder of the Peritoneal Carcinomatosis Program of Catalonia, dedicated to treating malignant neoplasms of the peritoneal surface. With over 30 years of experience in surgical treatment for advanced abdominal cancers, he also serves as a professor of surgery at the University of Barcelona. Throughout his professional career, he has delivered numerous lectures on the surgical treatment of advanced malignant abdominal neoplasms, both nationally and internationally. Currently, he holds the position of Head of the Advanced Peritoneal and Pelvic Oncological Surgery Center.
Case Record: CRS+HIPEC for recurrent Epithelial Ovarian Cancer (EOC). Clinical History. Patient #1: · Patient diagnosed with recurrent EOC (sensitive to platinum). Histology: mucinous tumor. Endocervical type · Clinical, biochemical, and radiological response. · Cytoreductive Radical Surgery plus Heated Intraperitoneal Chemotherapy (CRS + HIPEC) is proposed Other History: The radiological study was given at the diagnosis of the recurrence and the neoadjuvant CT treatment was finished Technique Description 1) Xiphopubic approach to the abdomen 2) Rigorous exploration of all abdominal-pelvic regions 3) Confirmation of the technical possibilities of complete cytoreduction with absence of visible tumor residue (CC-O) 4) Strategic design of the CRS by unifying all the peritonectomy procedures described by Sugarbaker in two surgical steps 5) Confirmation of the CC-O 6) Administration of the HIPEC in the open mode (Colosseum) Procedure Steps 1) Parietal peritonectomy, pelvic peritonectomy with rectosigmoid resection 2) Residual greater omentectomy, and splenectomy 3) Subphrenic right peritonectomy and lesser omentectomy 4) Digestive reconstruction. Colo-rectal anastomosis without stoma 5) "Colosseum" HIPEC: preparation and administration. Preparation and administration of chemotherapy for 60 min at 42.5ºC Learning Points · Role of CRS + HIPEC in recurrent EOC ovarian cancer · Use of Peritonectomy Procedures associated with visceral resection (Sugarbaker) to achieve complete CRS (macroscopic absence of tumor CC-O) · Technical modifications to the original peritonectomy procedures · Pelvic peritonectomy and rectosigmoid colon resection · Greater (residual) omentectomy and splenectomy · Left subphrenic peritonectomy · Lesser omentectomy and cholecystectomy with stripping of the hepatoduodenal ligament · Complete right subphrenic peritonectomy · “True” end to end colorectal mechanical reinforced anastomosis · Preparation and administration of the HIPEC in its “open” or coliseum modality · Personal series results. 146 patients treated for recurrent EOC over 1.240 CRS+HIPEC · Conclusions
With Rand Biotech
Published
Feb 2021
Patient diagnosed with Stage IIIC high-grade serous carcinoma of the ovary (extensive peritoneal dissemination with multivisceral involvement)
With Rand Biotech
Published
Feb 2021
Pseudomyxoma peritonei is the intraperitoneal dissemination of free mucus produced by adenomucinous tumoral cells. Originally thought to be secondary of a ruptured ovarian tumour, currently it is known that 90-92% of PMP have an appendiceal mucinous origin. The peritoneal lesions of the pseudomyxoma are the perfect example of tumour manifestation for which cytoreduction (CRS) and HIPEC has a rationale for therapy: it is a localized abdominal disease, with infrequent severe small bowel involvement, with high chances of complete cytoreduction, and most subtypes carry low biological aggressiveness. Therefore, currently the CRS-HIPEC is the standard treatment for pseudomyxoma in those patients with resectable disease. Optimal cytoreduction in pseudomyxoma peritonei is considered as CC-0 or CC-1, this means leaving macroscopic tumors of less than 0.25 cm. Besides complete cytoreduction, other prognostic factors are: the PCI, the prior surgical score, the lymph node involvement, the extensive o small bowel involvement, and the histology. Controversy exists concerning the histological classification, but an updated classification was recently developed by the International Peritoneal Surface Oncology Group. This, together with current evidence and the role of systemic chemotherapy and maximum debulking, will be discussed in this open classroom.
Published
Oct 2020
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